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Title: SU-F-T-630: Energy Spectral Study On Lipiodol After Trans-Arterial Chemoembolization Using the Flattened and Unflattened Photon Beams

Abstract

Purpose: SBRT combining transarterial chemoembolization with Lipiodol is expected to improve local control. Our showed that the dose enhancement effect in the Lipiodol with 10X flattening filter free (FFF) was inserted. This study was to investigate the energy fluence variations of electron in the Lipiodol using flattened (FF) and FFF beams. Methods: FF and FFF for 6X and 10X beams by TrueBeam were used in this study. The Lipiodol (3 X 3 X 3 cm{sup 3}) was located at the depth of 5 cm in water, the dose enhancement factor (DEF) and energy fluence were calculated by Monte Carlo (MC) calculations (PHITS). Results: DEFs with FF and FFF of 6X were 17.1% and 24.3% at rebuild-up region in the Lipiodol (5.3cm depth), 7.0% and 17.0% at the center of Lipiodol (6.5cm depth), and −13.2% and −8.2% at behind Lipiodol (8.3cm depth). DEFs with FF and FFF of 10X were 21.7% and 15.3% at rebuild-up region, 8.2% and 10.5% at the center of Lipiodol, and −14.0% and −8.6% at behind Lipiodol. Spectral results showed that the FFF beam contained more low-energy (0–0.3MeV) component of electrons than FF beam, and FF beam contained more high-energy (over 0.3MeV) electrons than FFF beam inmore » Lipiodol. Behind the Lipiodol, build-down effect with FF beam was larger than FFF beam because FF beam contained more high energy electrons. The difference of DEFs between FFF and FF beams for 6X were larger than for 10X. This is because 10X beam contained more high-energy electrons. Conclusion: It was found that the 6XFFF beam gives the largest change of energy fluence and the largest DEF in this study. These phenomena are mainly caused by component of low-energy electrons, and this energy is almost correspond to the boundary of photo electronic dominant and Compton scattering dominant region for photon beams.« less

Authors:
 [1];  [2]; ;  [3];  [2]; ; ;  [3]; ; ; ; ; ;  [1];  [4]
  1. Radiation Therapy Section, Department of Clinical Support, Hiroshima University Hospital, Hiroshima (Japan)
  2. (Japan)
  3. Department of Radiation Oncology, Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima (Japan)
  4. Department of Nuclear Engineering and Management, School of Engineering, University of Tokyo, Tokyo (Japan)
Publication Date:
OSTI Identifier:
22649190
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 43; Journal Issue: 6; Other Information: (c) 2016 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
60 APPLIED LIFE SCIENCES; 61 RADIATION PROTECTION AND DOSIMETRY; BLOOD VESSELS; COMPTON EFFECT; LIPIODOL; MONTE CARLO METHOD; PHOTON BEAMS; RADIATION DOSES; FUNDAMENTAL INTERACTIONS

Citation Formats

Kawahara, D, Medical and Dental Sciences Course, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Ozawa, S, Nagata, Y, Hiroshima High-Precision Radiotherapy Cancer Center, Hiroshima, Saito, A, Nishio, T, Suzuki, T, Hioki, K, Masuda, H, Okumura, T, Ochi, Y, Nakashima, T, Ohno, Y, and Tanaka, S. SU-F-T-630: Energy Spectral Study On Lipiodol After Trans-Arterial Chemoembolization Using the Flattened and Unflattened Photon Beams. United States: N. p., 2016. Web. doi:10.1118/1.4956815.
Kawahara, D, Medical and Dental Sciences Course, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Ozawa, S, Nagata, Y, Hiroshima High-Precision Radiotherapy Cancer Center, Hiroshima, Saito, A, Nishio, T, Suzuki, T, Hioki, K, Masuda, H, Okumura, T, Ochi, Y, Nakashima, T, Ohno, Y, & Tanaka, S. SU-F-T-630: Energy Spectral Study On Lipiodol After Trans-Arterial Chemoembolization Using the Flattened and Unflattened Photon Beams. United States. doi:10.1118/1.4956815.
Kawahara, D, Medical and Dental Sciences Course, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Ozawa, S, Nagata, Y, Hiroshima High-Precision Radiotherapy Cancer Center, Hiroshima, Saito, A, Nishio, T, Suzuki, T, Hioki, K, Masuda, H, Okumura, T, Ochi, Y, Nakashima, T, Ohno, Y, and Tanaka, S. Wed . "SU-F-T-630: Energy Spectral Study On Lipiodol After Trans-Arterial Chemoembolization Using the Flattened and Unflattened Photon Beams". United States. doi:10.1118/1.4956815.
@article{osti_22649190,
title = {SU-F-T-630: Energy Spectral Study On Lipiodol After Trans-Arterial Chemoembolization Using the Flattened and Unflattened Photon Beams},
author = {Kawahara, D and Medical and Dental Sciences Course, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima and Ozawa, S and Nagata, Y and Hiroshima High-Precision Radiotherapy Cancer Center, Hiroshima and Saito, A and Nishio, T and Suzuki, T and Hioki, K and Masuda, H and Okumura, T and Ochi, Y and Nakashima, T and Ohno, Y and Tanaka, S},
abstractNote = {Purpose: SBRT combining transarterial chemoembolization with Lipiodol is expected to improve local control. Our showed that the dose enhancement effect in the Lipiodol with 10X flattening filter free (FFF) was inserted. This study was to investigate the energy fluence variations of electron in the Lipiodol using flattened (FF) and FFF beams. Methods: FF and FFF for 6X and 10X beams by TrueBeam were used in this study. The Lipiodol (3 X 3 X 3 cm{sup 3}) was located at the depth of 5 cm in water, the dose enhancement factor (DEF) and energy fluence were calculated by Monte Carlo (MC) calculations (PHITS). Results: DEFs with FF and FFF of 6X were 17.1% and 24.3% at rebuild-up region in the Lipiodol (5.3cm depth), 7.0% and 17.0% at the center of Lipiodol (6.5cm depth), and −13.2% and −8.2% at behind Lipiodol (8.3cm depth). DEFs with FF and FFF of 10X were 21.7% and 15.3% at rebuild-up region, 8.2% and 10.5% at the center of Lipiodol, and −14.0% and −8.6% at behind Lipiodol. Spectral results showed that the FFF beam contained more low-energy (0–0.3MeV) component of electrons than FF beam, and FF beam contained more high-energy (over 0.3MeV) electrons than FFF beam in Lipiodol. Behind the Lipiodol, build-down effect with FF beam was larger than FFF beam because FF beam contained more high energy electrons. The difference of DEFs between FFF and FF beams for 6X were larger than for 10X. This is because 10X beam contained more high-energy electrons. Conclusion: It was found that the 6XFFF beam gives the largest change of energy fluence and the largest DEF in this study. These phenomena are mainly caused by component of low-energy electrons, and this energy is almost correspond to the boundary of photo electronic dominant and Compton scattering dominant region for photon beams.},
doi = {10.1118/1.4956815},
journal = {Medical Physics},
number = 6,
volume = 43,
place = {United States},
year = {Wed Jun 15 00:00:00 EDT 2016},
month = {Wed Jun 15 00:00:00 EDT 2016}
}
  • Purpose: This study investigates the spectra of surface photon energy and energy fluence in the bone heterogeneity and beam obliquity using flattened and unflattened photon beams. The spectra were calculated in a bone and water phantom using Monte Carlo simulation (the EGSnrc code). Methods: Spectra of energy, energy fluence and mean energy of the 6 MV flattened and unflattened photon beams (field size = 10 × 10 cm{sup 2}) produced by a Varian TrueBEAM linear accelerator were calculated at the surfaces of a bone and water phantom using Monte Carlo simulations. The spectral calculations were repeated with the beam anglesmore » turned from 0° to 15°, 30° and 45° in the phantoms. Results: It is found that the unflattened photon beams contained more photons in the low-energy range of 0 – 2 MeV than the flattened beams with a flattening filter. Compared to the water phantom, both the flattened and unflattened beams had slightly less photons in the energy range < 0.4 MeV when a bone layer of 1 cm is present under the phantom surface. This shows that the presence of the bone decreased the low-energy photons backscattered to the phantom surface. When the photon beams were rotated from 0° to 45°, the number of photon and mean photon energy increased with the beam angle. This is because both the flattened and unflattened beams became more hardened when the beam angle increased. With the bone heterogeneity, the mean energies of both photon beams increased correspondingly. This is due to the absorption of low-energy photons by the bone, resulting in more significant beam hardening. Conclusion: The photon spectral information is important in studies on the patient’s surface dose enhancement when using unflattened photon beams in radiotherapy.« less
  • Purpose: This study investigated the dosimetric impacts on the mucosa and bone when using the unflattened photon beams in radiotherapy. Dose calculations were carried out by Monte Carlo simulation. Methods: Heterogeneous phantoms containing water (soft tissue and mucosa), air and bone, with mucosa thicknesses varying from 0.5 – 3 mm were irradiated by the 6 MV unflattened and flattened photon beams (field size = 10 × 10 cm{sup 2}), produced by a Varian TrueBEAM linear accelerator. The photon energy spectra of the beams, mean bone and mucosal doses with different mucosa thicknesses were calculated using the EGSnrc Monte Carlo code.more » Results: It is found that the flattened photon beams had higher mean bone doses (1.3% and 2% for upper and lower bone regarding the phantom geometry, respectively) than the unflattened beams, and the mean bone doses of both beams did not vary significantly with the mucosa thickness. Similarly, flattened photon beams had higher mucosal dose (0.9% and 1.6% for upper and lower mucosa, respectively) than the unflattened beams. This is due to the larger slope of the depth dose for the unflattened photon beams compared to the flattened. The mucosal doses of both beams were found increased with the mucosa thickness. Moreover, the mucosal dose differences between the unflattened and flattened beams increased with the mucosa thickness. For photon energy spectra on the mucosal layers, it is found that the unflattened photon beams contained a larger portion of lowenergy photons than the flattened beams. The photon energy spectra did not change significantly with the mucosa thickness. Conclusion: It is concluded that the mucosal and bone dose for the unflattened photon beams were not more than 2% lower than the flattened beams, though the flattening filter free beams contained larger portion of low-energy photons than the flattened beams.« less
  • Purpose: Aim of this study is to compare the dose volume characteristics of 6X FFF (flattening Free Filter) Arc and 6X FB (flattened Beam) arc photon plans in SBRT technique. Methods: Eight patients who received linear Accelearator-based SBRT were retrospectively included in this study. A dose of 50 Gy was given to the target in five fractions. Same data set was used to generate plans for both FFF and FB. ITV was generated using maximum intensity projection and critical structures were derived using average intensity projection. PTV obtained by giving 0.5cm margin to ITV. Results: While both modalities can providemore » satisfactory target dose coverage, the dose to PTV was more heterogeneous in FFF than 6X FB plans in all cases. The doses in all plans were well below institutional constraints for both modalities. Comparing the results of Homogeneity Index(HI), Conformity Index(CI), PTV-D80% volume, D50% volume and D20% volume (Table-1 ) for both techniques, found all the indices are within limits of RTOG guidelines but the 6X FFF is superior in sparing normal tissues in compare with FB. In all cases studied, more treatment time was required for FB treatment delivery for a given prescription. The results indicate that for large dose delivery FFF is preferable as volumetric parameters like HI and CI are better and dose can be delivered in a short span of time. Conclusion: Both Flattened and Unflattened beam SBRT systems can provide adequate dose coverage for target tumor. While the unflattened beams deliver less normal tissue dose than Flattened beams in all cases. The magnitude of differences in normal tissue dose between both modalities was due to beam characterization of the beams. Flattened beam requires more Monitor Units to deliver similar target prescription to the tumor than unflattened beam SBRT systems. The results of this study may provide a general guideline for patient and treatment modality selection based on volumetric, tumor control and normal tissue sparing considerations.« less
  • Purpose: This study compared the dependence of depth dose on bone heterogeneity of unflattened photon beams to that of flattened beams. Monte Carlo simulations (the EGSnrc-based codes) were used to calculate depth doses in phantom with a bone layer in the buildup region of the 6 MV photon beams. Methods: Heterogeneous phantom containing a bone layer of 2 cm thick at a depth of 1 cm in water was irradiated by the unflattened and flattened 6 MV photon beams (field size = 10×10 cm{sup 2}). Phase-space files of the photon beams based on the Varian TrueBeam linac were generated bymore » the Geant4 and BEAMnrc codes, and verified by measurements. Depth doses were calculated using the DOSXYZnrc code with beam angles set to 0° and 30°. For dosimetric comparison, the above simulations were repeated in a water phantom using the same beam geometry with the bone layer replaced by water. Results: Our results showed that the beam output of unflattened photon beams was about 2.1 times larger than the flattened beams in water. Comparing the water phantom to the bone phantom, larger doses were found in water above and below the bone layer for both the unflattened and flattened photon beams. When both beams were turned 30°, the deviation of depth dose between the bone and water phantom became larger compared to that with beam angle equal to 0°. Dose ratio of the unflattened and flattened photon beams showed that the unflattened beam has larger depth dose in the buildup region compared to the flattened beam. Conclusion: Although the unflattened photon beam had different beam output and quality compared to the flattened, dose enhancements due to the bone scatter were found similar. However, we discovered that depth dose deviation due to the presence of bone was sensitive to the beam obliquity.« less
  • Purpose: Some modern linear accelerators are equipped with one low energy flat beam and two flattening filter free (FFF) beams at high and low energies. The purpose of this study is to investigate whether the high energy FFF beam can produce the same plan quality as the conventional low energy flat beam, using a volumetric modulated arc (VMAT) technique for prostate patients. Methods: Ten prostate cancer patients were selected with a prescription of 78Gy. For each patient, three plans were created: (a) double arc flat 6MV plan used clinically; (b) double arc 10MV FFF plan; (c) single arc 10MV FFFmore » plan. Each plan was prescribed so that at least 95% of the PTV received the prescription dose. The following dosimetric endpoints were evaluated: volume receiving 78Gy (V78) of the CTV and PTV, PTV conformality index (CI, ratio of prescription isodose volume to the PTV volume), bladder volume receiving 70Gy (V70) and 60Gy (V60), rectum volume receiving 70Gy (V70) and 50Gy (V50), dose to 10cc of the rectum, and volume of both femoral heads receiving 50Gy (V50). Total monitor units for each plan were recorded. Results: No significant difference was found for all dosimetric endpoints between all plans (p>0.05). Compared to the 6MV plans, monitor units were higher with the double arc 10MV FFF plans and lower with the single arc 10MV FFF plans, 29% and 4% respectively. Conclusion: Both single arc and double arc 10MV FFF VMAT can achieve equivalent plan quality as 6MV flat beam double arc treatment plans. With the gantry speed restriction, a high dose rate of 2400MU/min may allow the optimizer to use more MUs than actually needed. Single arc 10MV FFF VMAT plans are a reasonable alternative to double arc 6MV flat beam VMAT plans.« less